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Health Care Reform With Out High Tech: Changing a Culture of Fatness to a Culture of Fitness

Posted Jan 26 2009 5:03pm

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photo: flickr.com

 

President Obama has a stimulus package all ready to roll out.  Reportedly, it will include money ear marked to expand COBRA.  If this is true, there will be precious little left to fund the ‘everybody has to have an EMR’ mandate.

Good, I say.  Let’s work on some low tech solutions that will reap true benefits.  Yes, I admit that the low tech, grunt it out in the trenches approach is not nearly as sexy as an EMR with bells and whistles, but this time, I think low tech will trump high tech.  Here goes the PookieMD save the world through hard work approach:

First, focus on America’s growing middle.  Here are five low tech ways to cut the fat and increase activity.  (Literally and figuratively!)  I will work from the global to the micro.

  1. Mandate the physical education be held every day from kindergarten through 12th grade.  Our plump kids are the diabetics  and cardiac stentees of tomorrow.   Making time for health now will pay off immensely later as we make physical movement a daily part of children’s day.  (By the way, cup stacking is not a sport!  Getting the heart rate up counts!  For a great look on what happens when schools institute a required daily physical education class read Spark, by John Ratey, MD.  Hint: test scores go up, learning improves and discipline problems go down.  Pretty good for having a bunch of kids run around a track!)
  2. Offer tax benefits to companies that have in house exercise programs.  Tax benefits would be proportional to percentage of employees participating.  We need to change the culture of fatness into a culture of fitness.
  3. Get your office workers in shape.  With all due respect, many times the office help are bigger than the patients.  One practice I know had a very successful biggest loser competition.  Why don’t YOU sponsor it, and include yourself? Consider a small prize (gift basket with soaps/lotions?) for the biggest loser.  Of course, absentee rates and sick days will go down as you and your staff get more fit.
  4. Make fitness a part of your office culture.  Have info on health clubs, classes, rec centers available.  Consider a group visit for obese patients, focusing on exercise. Do group walks, enter a 3 k, host a weight watcher type group, do SOMETHING.  Getting your office in the news would be a nice side benefit.
  5. Encourage patients to “chunk”.  (No we don’t want chunky patients!)  The surgeon general recommends 30 minutes of exercise daily.  Encourage the couch  potatoes to start by walking 15 minutes two times a day, or 10 minutes 3 times per day.  There is no law that says it should be all at once, although it’s a good goal.  For the  obese, a gym can be intimidating, so start simple: encourage walking, then jogging, and then maybe a trip to the gym.  It doesn’t get much easier than a walk around the block or up the stairs.  (You do take the stairs at the hospital don’t you?)  Additionally, the television is filled with exercise shows–for those who still can’t tear themselves away from the small screen.

These ideas aren’t new, definitely aren’t sexy, and won’t get your sponsorship from a drug company.  However, they will work and we, as physicians, hold the keys.  We need to start with legislation, and move on to what we as ‘health coaches’ can do.    We can have huge impact on the huge, and not so huge.  Please, please, let me know what WE can do together to move our country to health, starting TODAY in our medical officese and clinics.

      
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